NPI 1962456905 · live from the CMS NPI Registry
Richard Joseph Provenzano, M.D.
Ophthalmology in Bennington, VT. National Provider Identifier 1962456905, active.
NPI record
| NPI | 1962456905 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Ophthalmology 207W00000X |
| Practice location | 322 Dewey St, Bennington, VT 05201 |
| Practice phone | 802-447-8700 |
| Enumerated | May 22, 2006 |
| Last updated | March 30, 2018 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Ophthalmology | 207W00000X | 45884 (MA) |
| Ophthalmology primary | 207W00000X | 042-0006501 (VT) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.